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13-0840 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000840 Property Address: 51984 AVENIDA HERRERA APN: 773-173-034- -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 10135 Applicant: ov4lfz�� T,iht 4 VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT ;Date: 7/09/13 Owner: DEAN GARY W 51984 AVENIDA HERRERA MORENO VALLEY, CA 92553 ( Contractor: Architect r gi GENERAL AIR CONDITIONING 31170 RESERVE DRIVE JUL 09 2013 THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 -4- License No.: 686310 �/ Da� % q ContractoJ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the . following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of- Section 7031 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.(. (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: — Lender's Address: LQPERbt[T 7 ---------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� Dater � Applicant:"'] St� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director, of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county tenter upon the above-mentioned propertyfor inspection purposes. Dater'! .a Signature (Applicant or Agent): fC'>ita.�rl ti t Application Number . . . . . 13-00000840 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/05/14 Qty Unit'Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE (4) TON HEAT PUMP PACKAGE UNIT 78% AFUE 15 SEER 2008 ENERGY CODES CARBON MONOXIDE ALARM(S)TO BE INSTALLED PRIOR TO FINAL INSPECTION 2010 CBC. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 47.66 Fee summary Charged Paid Credited - -- ---------- ---------- ---------- Due ----------------- ------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 139.23 .00 .00 139.23 Grand Total 210.73 .00 .00 210.73 L.QPFRMIT Bin # Qty Of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # \j Project Address: 1 q ;8 y AV t _n` Owner's Name: ax LeA A. P. Number: Address: 51984 Atie , c,c. j.{ ex re✓r ct. Legal Description: City, ST, Zip: Lo. iQugrao, C -A, q 2i 53 Contractor: y Y telephone: - 10 Address: 311-70 --�ec-vim Project Description: City, ST, Zip:'hp y� tf�m s C'A g2Z70 e �acx— N eccA Wm - c Telephone: %(00 3e+3. 74$8 1.�� State Lic. # : City Lic. #.. Arch., Engr., Designer: Address: City, ST, Zip: Tele hone: %`?:><;<>;:::s»>:;s:#>:;::< ConstructionT a Occupancy: State Lic.#: h'P � Project a (circle New Addn Alter Re J ) ' air Demo P Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Coles. Called Contact Person Pian Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: 7City Enforcement Agency: Date: Permit #: 51984 AVENIDA HERRERA La Quinta, CA 92253 of La Quints I Jul 7, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ® Package Unit ❑ Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ❑ Indoor Coil ® SEER 15.0 ❑ HSPF ❑R 8 (CZ 14-15) 1389 sf If not already present, must be [3 Condensing Unit 0 EER p Resistance installed) Q Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -6111 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS replaced CF -4R forms: MECH-21 and (F^- split systems) MC!`H 2- . Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (ter split systems) NEGH-25-WEIRS . Indoor Coil and /or CF -4R forms: MECH-21 . Furnace : RG, GGA - , For Packaged Units: Duct leakage': 15 percent Exempted from duct4eakage testingaf:. .� 1: Duct system was dOCUrn4in iid to have been previously sealed and confirmed through HERS verification, or . Q 2; Duct systems with less thati:40 linear feet in unconditioned space, or 03. Existing duct systems are constructed, insulated or sealed with asbestos 4: The s stein will not be Ducted (ie >DctlessrtM►nr 3 " tSy tertr (A}soExerrptfiframRe#cigeraiit r`tlar e) .. �`.:_. ? ... 3 ❑ 2..Neta► HVAC 5 Mein .........:.... Re ut-edi>Farms:: t - : :;c° -_ '.: .:::..�..: - �atec� �'>rt�:["�'.-4 f:•e.�;, ;: . <:= .Cut tn, or Cpangeout witia=., -: 5:: ;.:-.tyyl�y:_,.;['.ice "�,.:: .3'.r -r:=•"5:;..-`'..... .:�;eE�?`.`.:;.-d>;`:. ''S'7:::.. 4 �� n� 1. .....:.:.: ................:...... ��6(�'forn-rs�MECH-04, MECFl;24l�liERS�arxdx„>.foi`sPl'tt sys€ems) NIECN: Zr2"HERS; aitd.:. --� new du ?::(all new ductitt a d all new du MEGta'S HERS 4 X:..,. � �x � r ;:. %: . pit S�r�'_tr" Ea. r. CF-4iZ forfrts {MECH-O,nd for sy�tems}MFCH 22; iin:�lEr � �� .:.. •. . equtpmen_'` split •4 ,, a -?S�b`H+1,iU�u .+.1� . ..4D:.-rcJUYa 4R. For Sp rrc Systems: Duct'feakage 6erent Its, CG°`35fl LfMjtari EWD; TNIAH, S?NiS, and ei$fier F15PP'or'PSPP. For Packaged Units; Duct leakage.. 6.percent.. ❑-3:;New: Ducts Mfith/or without:::;=::: Required Forms: . Includes replacing or installing WF -*.---new ducting and/or outdoor coizderi5i6dg-unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/orfo6hare ;No or some CF -4R fortes: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >- 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 17 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) . I certify that this Certificate of Compliance documentation is accurate and complete. . I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. . The design features identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: banielle Garcia Company: HARRISON ENTERPRISES INC Date: Jul 7, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-A0050035A-000000000-0000 Registration Date/Time: 2013/07/07 17:36:35 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forme July 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 51984 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-840 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Vote: Submit one Installation Certificate for each duct system that must demonstrate compliance in the 1welling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakaae Diaanostic Test - existina duct system Select one compliance method from the following four choices. IN 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow (3 3. Reduce leakage by 60% and conduct smoke and fix all leaks p 4. Fix all accessible leaks using smoke"and HERS rater verify Note: (One of Options1, 2 or 3 must be attempted before utilizing,Ogtion_4.) �_____ Determine.nominal Fan Flow using one ofthe'following three calculation methods.," ✓ IN Coolingr system method: Size of con=denser in Tons- 4 x,400.=° 1600 CFM Y ✓ O Heating system method 21.7 x _ Output" Capacity in. Thousands of Btu/hr = = CFM ✓ ❑ Measured system airflow using RA3.3 airfloWAestprocedures -"_ CFM - Option 1 used.then: 1,. Allowed leakage = Fan Airflow 1600 x 0..15 = 240 CFM Actual Leakage = 187 CFM Pass if Actual Leakage is less than Allowed leakage 11 Pass Fail Option 2 used then: 2 • Allowed leakage = Fan Airflow x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Actual leakage to outside is less than Allowed leakage Q Pass 0 Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage__) x 100% _ °/a Reduction Pass if "/o Reduction >= 60% 13 Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke 13 Pass Fail Reg: 213-A0050035A-M2100001A-0000 Registration Date/Time: 2013/08/13 19:26:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 51984 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-840 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage. testing. CFI -OA ducts that utilize controlled motorized dampers, that open only when OA ,ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ® All supply and return register boots must be,�sealed to the'drywall:if,smoke'test is utilized for,'compliance - applies°to'duct leakage compliance optionv3-(leakage reduction.by'60%),and optior 41(fix.all accessible ' leaks) described above." ® New duct installations cannot utilize building cavities as4plenumal6r platform returns in lieu of,d`ucts , ® Mastic and -draw bands must.be used,in combination with cloth backed rubber adhesive ducttape to seal leaks at all new duct connections DECLARATION STATEMENT • I certifyunder penalty of perjury, p ty p O ry, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: Danielle Garcia banielle Garcia CSLB License: Date Signed: 17/9/2013 Position With Company (Title): 686310 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? p Yes p No Reg: 213-A0050035A-M2100001A-0000 Registration Date/Time: 2013/08/13 19:26:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 51984 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quin ta 13-840 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to duct Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakaqe Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by: 60% and conduct smoke and fix all leaks Fix ❑ 4 all accessiblleaks using smoke oke and HERS rater verify Note: `(One of Qptionsxi1, 2, or 3 must,be.attemptgd%bgore,utilizing Qption4:): Determineominal:Fan >Flow using one ofAhe following three calculation methods . rg , T ✓ O Cooli g'system method Size ofccondenser in Tons x 400 L CFM ✓ ❑ Heating system method 21 7 x Output Capacity m Thousands of Btu/hr CFM ✓ ❑ Measuredsys$em airflowusing RA3 3 auflow e'st procedures W_ CF�� Option i used then # Allowed 1 leakage . Fan Flow x 0'.:l5' .. -CFM , a Actual,Leakage CFM ` r Pass if Leakage Actual is less than Allowed 0 Pass 0 Fail Option:2 used then:;",.. `z 2 Allowed leakage = Fan -Flow 0.10 = _ CFM Actual Leakage to outside:- t:: CFM Pass if Leakage Actual is.less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test. _ CFM 3 Initial -leakage - Final leakage _ = Leakage reduction CFM _ ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction >= 60% Pass rl Fail Option 4 used then: 4. All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke Pass Ll Fail r ; S -Reg: 213-A0050035A-M2100001A-M21A Registration Date/Time: 2013/08/13 20:01:25 HERS Provider: CalCERTS, Inc. '2008. Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 51984 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quints 13-840 ❑Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off. during Tduct leakage/testing. CFI. 0A ducts that utilize controlled motorized dampers, that open only when OA :ventilation. is requil'ed to meet ASNRAE Standard 62.2, and close when OA ventilation is not required, may be'configumd. to the closed position: during duct leakage testing. ❑•AII s6ppl,7/6nd, ret6rh register-boots``must bejsealed applies�to`duct leakage compliance option 3:(leakac leaks) described abov ' ❑ New duct installations cannot ut ze,buildin-g.cavltii Bst is utilized for; compliance option`�4,,(fix all accessible. YJ ❑ Mastic and.draw bands must be used: in,,cornbffik' .with cloth;backed.rubber 'ad hes�ive duct 6pe to seal leaks at all new duct connections. DECLARATION STATE,MENTr . I certify under penalty of per)ury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -SR) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: 1686310 Danielle Garcia HERS Provider Data Registry Information Sample Group # (if applicable): 433058 ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798773032 HERS Rater Company Name: Stratz Permit Service Responsible Rater's Name: Responsible Rater's Signature: Garrett Williams Garrett Williams Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 7/29/2013 CC2006208 Reg: 213-A0050035A-M2100001A-M21A Registration.Date/Time: 2013/08/13 20:01:25 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010